Prevalence of diabetes and impaired fasting glucose in Poland--the NATPOL 2011 Study.

AIMS: The aim of the analysis was to assess the prevalence of diabetes and impaired fasting glucose in Poland. METHODS: A questionnaire survey on a representative sample of 2411 Polish adults, complemented by blood pressure, anthropometric and fasting plasma glucose measurements. The research was part of the national cross-sectional NATPOL 2011 Study. Diabetes was assessed as self-reported (diagnosed) or screened (fasting plasma glucose level ≥ 7 mmol/l, based on one blood draw). RESULTS: Total prevalence of diabetes in 2011 was 6.7% (95% CI 5.6-7.9); 6.4% (95% CI 5.0-8.0) in women and 7.0% (95% CI 5.4-8.8) in men and did not change from 2002 (6.8%, 95% CI 95% CI 5.8-7.9). Over one quarter of individuals with diabetes were not aware of having the condition. Obesity, arterial hypertension and male gender were strong predictors of screened diabetes. Total prevalence of impaired fasting glucose in the surveyed population was 15.6% (95% CI 14.0-17.2). CONCLUSIONS: The prevalence of diabetes in Poland is similar to that observed in other European populations and has not changed over the last decade. The fact that every fourth person with diabetes is unaware of the disease creates important opportunities for screening and detection of the disease.

General medical burden in bipolar disorder: findings from the LiTMUS comparative effectiveness trial.

OBJECTIVE: This study examined general medical illnesses and their association with clinical features of bipolar disorder. METHOD: Data were cross-sectional and derived from the Lithium Treatment - Moderate Dose Use Study (LiTMUS), which randomized symptomatic adults (n = 264 with available medical comorbidity scores) with bipolar disorder to moderate doses of lithium plus optimized treatment (OPT) or to OPT alone. Clinically significant high and low medical comorbidity burden were defined as a Cumulative Illness Rating Scale (CIRS) score ≥4 and <4 respectively. RESULTS: The baseline prevalence of significant medical comorbidity was 53% (n = 139). Patients with high medical burden were more likely to present in a major depressive episode (P = .04), meet criteria for obsessive-compulsive disorder (P = .02), and experience a greater number of lifetime mood episodes (P = 0.02). They were also more likely to be prescribed a greater number of psychotropic medications (P = .002). Sixty-nine per cent of the sample was overweight or obese as defined by body mass index (BMI), with African Americans representing the racial group with the highest proportion of stage II obesity (BMI ≥35; 31%, n = 14). CONCLUSION: The burden of comorbid medical illnesses was high in this generalizable sample of treatment-seeking patients and appears associated with worsened course of illness and psychotropic medication patterns.

Vitamin E supplement use and the incidence of cardiovascular disease and all-cause mortality in the Framingham Heart Study: Does the underlying health status play a role?

BACKGROUND: Observational studies generally showed beneficial associations between supplemental vitamin E intake and cardiovascular disease (CVD) risk whereas intervention trials reported adverse effects of vitamin E supplements. We hypothesize that these discordant findings result from differing underlying health status of study participants in observational and intervention studies. OBJECTIVE: Determine if the relation between supplemental vitamin E intake and CVD and all-cause mortality (ACM) depends on pre-existing CVD. DESIGN: Proportional hazards regression to relate supplemental vitamin E intake to the 10-year incidence of CVD and ACM in 4270 Framingham Study participants stratified by baseline CVD status. RESULTS: Eleven percent of participants used vitamin E supplements at baseline. In participants with pre-existing CVD, there were 28 (44%) and 20 (32%) incident cases of CVD and ACM in the vitamin E supplement users versus 249 (47%) and 202 (38%) in the non-users, respectively (CVD HR, 0.90; 95% CL, 0.60-1.32; ACM HR, 0.74; 95% CL, 0.46-1.17). In participants without pre-existing CVD, there were 51 (13%) and 47 (12%) cases of CVD and ACM in the vitamin E supplement group versus 428 (13%) and 342 (10%) in the non-vitamin E supplement group, respectively (CVD HR, 1.00; 95% CL, 0.75-1.34; ACM HR 1.20; 95% CL, 0.89-1.64). CONCLUSION: CVD status has no apparent influence on the association of supplemental vitamin E intake and risk for CVD and ACM in this large, community-based study. Further research is needed to clarify the basis for the discrepant results between intervention and observational studies of supplemental vitamin E intake.